Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders today, and approximately 8.4% of children and 2.5% of adults live with ADHD. Research indicates that ADHD is more commonly diagnosed in men, affecting about 5.5% of them, whereas the rate among women is considerably lower, at around 2.2%. Meanwhile, in Western European countries, the average male-to-female ratio is 6:1; in Eastern Europe, the difference is more pronounced, approximately 8:1.
This disparity doesn’t mean women are less likely to have ADHD. It means that they are far less likely to get diagnosed. In Eastern Europe, the number of ADHD patients is still lower, which reflects a lack of understanding of how mental disorders affect women and gender biases in healthcare.
What ADHD Really Looks Like
According to the DSM-5, the standard psychiatric manual for diagnosing mental disorders, ADHD is a neurodevelopmental disorder, meaning that it is a condition that affects how the brain works. The symptoms are inattention (difficulty sustaining focus), hyperactivity (difficulty sitting still), and impulsivity (urgent actions without considering consequences). Consequently, many people living with ADHD are highly creative and energetic, but also forgetful and disorganized, which affects many aspects of life, both professional and interpersonal relationships. It often leads to difficulties in social and academic functioning and to low self-esteem, with a high sensitivity to criticism.
Despite its name, ADHD isn’t simply a “deficit” of attention—it’s a difficulty regulating emotions. The symptoms result from a lack of regulation, not a lack of attention, which makes the naming somewhat misleading. These symptoms originate from brain mechanisms, most notably impairments in the frontal part of your brain, which is responsible for planning, attention, and impulse control. This condition is also linked to dysregulation and reduced levels of neurotransmitters (dopamine and norepinephrine), which help the brain control mood, attention, and movement by sending signals.
There are three recognized types of ADHD, each defined by the dominant symptom cluster:
- Hyperactive-Impulsive Type: Often diagnosed in men, this type involves excessive movement, fidgeting, talking over others, and difficulty waiting one’s turn. Hyperactive-Impulsive ADHD, which is more commonly diagnosed in men, is characterized by constant movement, fidgeting, interrupting others, excessive talking, and difficulty sitting still or waiting their turn.
- Inattentive Type (formerly called ADD): More common in women, this type includes difficulty focusing, forgetfulness, daydreaming, disorganization, and struggling with instructions. Inattentive ADHD (formerly known as ADD) tends to be more common in women and includes symptoms such as trouble focusing, forgetfulness, daydreaming, disorganization, and difficulty following instructions.
- Combined Type: A mix of both inattentive and hyperactive-impulsive symptoms, seen across all genders. Combined Type ADHD has an equal blend of both inattentive and hyperactive-impulsive symptoms.
How Gendered Science Skewed the Diagnosis
Since the early 20th century, scientific and medical research has largely focused on male patients. Most clinical trials, case studies, and diagnostic criteria for neurodevelopmental disorders like ADHD were based on how symptoms appeared in boys and men, with little attention given to how these conditions might manifest differently in girls and women.
This focus wasn’t always intentional. Symptoms in boys are more visible and disruptive as boys with ADHD are more likely to show signs of hyperactivity and impulsivity, such as running around classrooms and interrupting teachers. These symptoms are difficult to ignore.
Girls, however, often show more internalized symptoms (inattentiveness, disorganization, daydreaming, and emotional sensitivity) that characterize the Inattentive Type of ADHD. At the same time, because of the different expectations society has for women, they often try to “mask” their ADHD symptoms and act “normal” as a coping strategy. This takes a lot of effort and may lead to more severe anxiety and depression, since many women are taught to suppress their true feelings and struggles. Therefore, the typical symptoms of ADHD in females can easily be misunderstood as personality traits, laziness, or just being emotional, rather than being recognized as symptoms of ADHD.
This misinterpretation has created a pattern of misdiagnosis that continues to affect women today. Due to stereotypes portraying women as inherently more emotional, they face significantly higher rates of misdiagnosis with mood and anxiety disorders. Research shows that females with ADHD are twice as likely as males to receive depression or anxiety diagnoses and treatment in the year before their ADHD diagnosis. This only delays proper treatment but can also result in inappropriate treatment for the actual condition.
This creates a double burden for women living with ADHD: they have to cope with both societal gender expectations, being naturally organized, emotionally stable, and nurturing, and struggling with untreated ADHD that makes meeting these very expectations extraordinarily difficult. Because girls are less likely to be diagnosed in childhood, their academic path is difficult from the beginning. Without understanding why they struggle, they internalize failure as personal inadequacy rather than recognizing it as a treatable neurological difference, affecting their self-esteem, social relationships, and future opportunities.
A Pattern of Misdiagnosis
Zsófia (24), who grew up in Hungary, experienced this firsthand. “I started struggling in my personal life after I began my university studies. I’ve always felt different from other kids. My teachers often described me as ‘someone who lives in the clouds’ because I was frequently daydreaming. However, as a child, despite having these symptoms, they didn’t affect me significantly. But after moving out on my own, I faced several challenges and quickly fell into depression. It got to the point where I was experiencing severe suicidal thoughts and urgently needed help,” she explains.
“I wanted to speak to someone from my home country, and I managed to get an appointment with both a psychiatrist and a psychologist. After the consultation, they gave me shocking news: they suspected I might have Borderline Personality Disorder, depression, or Bipolar Disorder. Without a confirmed diagnosis, they immediately wanted to prescribe me antidepressants and Xanax. Before that, I had even mentioned that I thought I might have ADHD and asked to be evaluated for it.”
Later, while temporarily living in the Netherlands, Zsófia was referred to an in-person mental healthcare facility. There, she met a Dutch psychiatrist who told her he was “90% sure” she had ADHD. “He explained that emotional sensitivity and impulsiveness are common in women with ADHD, but are often overlooked. He referred me to a diagnostic centre—and surprise, I was officially diagnosed with ADHD. After starting medication, my life completely changed. Most of my depressive symptoms disappeared, and I became far more functional.”
Getting professional help, however, took nearly two years. “One of my male friends, who also has ADHD and encouraged me to get diagnosed, got his diagnosis almost immediately, similarly at a private clinic.’’
Zsófia doesn’t blame the doctors or the facilities. “I believe they genuinely tried to help. But there is a structural issue in how women’s healthcare is approached. In the Netherlands, doctors are specifically trained to recognize gender bias, whereas in many universities in my country, this is not the case.
Stigma and Silence in Eastern Europe
Despite the growing awareness in Western European countries, gender norms and traditional views continue to influence how women are treated in mental healthcare across Eastern Europe. As Zsófia’s experience shows, this gap itself reflects how Eastern European women’s experiences with ADHD are largely different.
Although this gender gap is known in the psychiatric community, there is a notable lack of research that specifically examines ADHD in women within the cultural context of Eastern Europe. Women in the region are assigned to a more traditional gender role than Western Europeans. The management of household responsibilities, providing emotional support, and staying organized creates additional pressure that many women face daily. Balancing these expectations with ADHD is extremely challenging.
On the other hand, mental health is still stigmatized across Eastern Europe. Countries report significantly higher levels of mental health stigma at all levels of society compared to their Western European counterparts. In some regions, admitting you see a psychologist or psychiatrist is still considered a sign of weakness or failure to cope, which is a cultural attitude rooted in generations of “just push through” mentality.
The mix of traditional gender roles and the pressure on women to stay organized, provide for others, combined with the strong stigma around mental health in the region, makes life especially hard for women with ADHD. All of this adds up to a bigger problem: cultural expectations and stigma work together to stop women from getting the help they deserve, which perpetuates gender inequalities in mental healthcare across Eastern Europe.
How We Can Support Women With ADHD
Rising awareness of how ADHD affects women is an important step towards more equitable mental healthcare. But change needs to go beyond awareness, especially in countries where many people still face stigma when talking about mental health, and women live in different conditions. ADHD is often misunderstood, and women’s symptoms are easily mistaken for something else.
Promisingly, younger generations are increasingly speaking up about mental health. Women are less afraid to ask for help and share their stories, which is already challenging the stigma about ADHD in women. However, there is a need for cultural change in Eastern European healthcare systems and in education. Medical schools and psychology courses across Eastern Europe should include gender-sensitive training that teaches them to recognize differences in symptoms across genders. At the same time, research should include studies in different cultural settings. This would help more women get the right diagnosis and treatment earlier.
Real change will happen when women are finally seen, heard, and given the right support in mental healthcare.
Edited by Atena Abbaspourbenis
